Endobronchial Ultrasound Elastography for Differentiating Benign and Malignant Lymph Nodes

Gompelmann, Daniela; Kontogianni, Konstantina; Sarmand, Nilab; Kaukel, Philine; Krisam, Johannes; Eberhardt, Ralf; Herth, Felix J.F.

doi:10.1159/000509297

Cited by 10 publications

(18 citation statements)

References 13 publications

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“…Consistent with previous studies with a sensitivity in EBUS-elastography ranging from 71% -90.6%, our study showed a sensitivity of 90.5%. However, the corresponding speci city was only 57.3% in our study which was lower than other studies (67%-82.6%) (Fournier et al 2019;Gompelmann et al 2020;Lin et al 2019). We believe that the discrepancy could be due to the multiple factors related to the nal results during the EBUS-elastography, eg.…”

Section: Discussioncontrasting

confidence: 83%

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Huang¹,

Lü²,

Wang³

et al. 2021

Preprint

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Background: Endobronchial ultrasound (EBUS) elastography has been applied in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on the tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely used for onsite evaluation of the adequacy of the samples and guiding the sampling during EBUS-TBNA. The aim of the study is to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating of mediastinal and hilar lymph nodes status.Methods: A retrospective chart review was performed from December 2018 to September 2020. Patients’ demographic, EBUS elastography score, ROSE, pathologic and clinical outcomes were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly non-blue; Type 2, partially blue and partially non-blue; Type 3, predominantly blue. Receiver operating characteristic (ROC) curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio among EBUS elastography, ROSE, and EBUS combined with ROSE groups for evaluation of malignant lymph nodes.Results: A total of 247 patients (345 lymph nodes) were included in our study. The sensitivity and specificity of EBUS elastography group in the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE alone group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE group were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under curve was 0.942.Conclusions: The combination of EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph nodes status.

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Section: Discussioncontrasting

confidence: 83%

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Huang¹,

Lü²,

Wang³

et al. 2021

Preprint

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“…Consistent with previous studies that found EBUS elastography sensitivity ranging from 71% to 90.6%, this study showed a sensitivity of 90.5%. However, the specificity was only 57.3%, which was less than that in other studies (67% to 82.6%) [ 13 , 30 , 36 ]. This discrepancy may result from multiple factors related to the final results during EBUS elastography, e.g., calcification or necrosis in the lymph nodes [ 3 ].…”

Section: Discussioncontrasting

confidence: 71%

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

et al. 2021

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Background Endobronchial ultrasound (EBUS) elastography has been used in EBUS-guided transbronchial needle aspiration (EBUS-TBNA) to identify malignant lymph nodes based on tissue stiffness. Rapid onsite cytological evaluation (ROSE) has been widely utilized for onsite evaluation of sample adequacy and for guiding sampling during EBUS-TBNA. The aim of this study was to investigate the diagnostic value of combined EBUS elastography and ROSE in evaluating mediastinal and hilar lymph node status. Methods Retrospective chart review was performed from December 2018 to September 2020. Patient demographics, EBUS elastography scores, and ROSE, pathologic, and clinical outcome data were collected. The EBUS elastography scores were classified as follows: Type 1, predominantly nonblue; Type 2, partially blue and partially nonblue; and Type 3, predominantly blue. A receiver operating characteristic curve was used to compare the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for evaluation of malignant lymph nodes among the EBUS elastography, ROSE, and EBUS combined with ROSE groups. Results A total of 245 patients (345 lymph nodes) were included. The sensitivity and specificity of the EBUS elastography group for the diagnosis of malignant lymph nodes were 90.51% and 57.26%, respectively. The sensitivity and specificity in the ROSE group were 96.32% and 79.05%, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of EBUS elastography combined with ROSE were 86.61%, 92.65%, 11.78, and 0.14, respectively, and the area under the curve was 0.942. Conclusions Combining EBUS elastography and ROSE significantly increased the diagnostic value of EBUS-TBNA in evaluating mediastinal and hilar lymph node status compared to each method alone.

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“…Figure 1 shows the flow chart of the study selection. Finally, 17 publications were included in this meta-analysis [14][15][16][23][24][25][26][27][28][29][30][31][32][33][34][35][36].…”

Section: Study Selectionmentioning

confidence: 99%

“…The 17 enrolled studies were published between 2014-2020 and written in English [14][15][16][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. A total of 1360 patients with 2307 hilar and mediastinal LNs were included in these studies.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…A total of 1360 patients with 2307 hilar and mediastinal LNs were included in these studies. Five studies were performed in China [15,23,[27][28][29], 3 in Japan [14,24,35], 2 in Netherlands [16,33], 1 in Slovenia [25], 1 in Thailand [26], 1 in Taiwan [30], 1 in Spain [31], 1 in France [32], 1 in Turkey [34] and 1 in Germany [36]. There were 10 prospective [15,16,25,26,29,[31][32][33][34]36] and six retrospective [14,24,27,28,30,35] studies and one study did not depict the study design [23].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

Sun

Wang

et al. 2022

Med Ultrason

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Aims: In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs). Material and methods: A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs. Results: Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88). Conclusion: EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.

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Endobronchial Ultrasound Elastography for Differentiating Benign and Malignant Lymph Nodes

Cited by 10 publications

References 13 publications

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Diagnostic value of endobronchial ultrasound elastography combined with rapid onsite cytological evaluation in endobronchial ultrasound-guided transbronchial needle aspiration

Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

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